Is There Sex After Prostate Cancer?

As a couple, you have gotten the chilling diagnosis: It’s prostate cancer. The good news is, if it was caught early, and you are the male in this duo, you aren’t likely to die of the disease (the five-year survival rate is actually 100% when the cancer is still local or regional), and there are plenty of options for treatment available.

But does this disease mean an end to your sex life?

No, but it does mean your sex life is going to change—for both of you.

Here’s a few suggestions for making it through a tough time and still keeping the fire (even if it’s more embers and less logs) burning between you:

Read all you can about the disease

Men: Be realistic, not overly optimistic. You will never be 19 again (and be honest, you probably didn’t perform like you were that age even before treatment), but also note that nerves sometimes regain more function even three years after treatment. Women: Set your mind to be supportive, even during the dark periods where he feels like he’s just done in the sex department. Realize it has been a big part of his life and now it’s threatened. Be ready for some anger and depression.

Expect some dysfunction

It’s going to get different. Odds of recovering erectile function vary widely and depend on a host of factors, including type of treatment and the patient’s age, race, PSA level and sexual potency before treatment, but you may expect fewer and less firm erections and possibly even a difference in the degree of his orgasm. One man put it, “I can still hear the horn section, but no longer hear the whole orchestra. Women: Don’t feel personally rejected if he can’t perform. Combine cancer, some scary kind of therapy that affects his penis (his true staff of life), age, and performance anxiety, and you’ve got great grounds for impotence.

Don’t brush it off:

If both of you want to have sex, give it a go—with the understanding that if “normal” intercourse doesn’t work, you will substitute oral sex or a loving massage or a bubble bath together. Don’t say “It doesn’t matter” because it does …to you both. Hold and caress one another and feed the skin hunger you will feel. Anxiety breeds loneliness, even though you are together.

Pills and penile implants

If the man is a cardiac patient,Viagra and Cialis, which work well, are probably not a safe option. But if he decides to have penile implants (a cylinder is placed in the penis with a small reservoir and pump, resulting in good erections and sometimes even better satisfaction than existed with a natural erection before surgery) or penile injections, back him up in his decision, women. It is, after all, his penis.

Some things to try

The man may want to stand or kneel upright (as opposed to laying down), to increase blood flow to the penis. Incorporate toys, videos, or side-by-side masturbation. Teach each other that all the skin on your bodies is one big sexual organ. Use this list of sensate focus exercises to explore that idea: and take the pressure off you both. It is also good to remember that a man does not need an erection to experience an orgasm.

Be patient

Both of you need to give this some time. Prostate cancer is a big rock thrown in your pond, but together—eventually—you can learn to deal with the ripples and get safely (and sexily) to the shore together.